Diabetes mellitus (di"ah-BE'teez or di"ah-BE'tis meh-LI'tis)
is the inability of the body to produce or respond properly to
the
hormone insulin. The body needs insulin to convert glucose ("blood
sugar") into energy. Diabetes is defined as a fasting plasma
glucose of 126 mg/dL or more measured on two occasions.

The two major forms are type 1 and type 2 diabetes. Type 2 diabetes,
the most common form, usually appears in adults, often in middle
age. Type 2 diabetes is often linked with obesity and may be delayed
or controlled with diet and exercise. (Obesity and physical inactivity
are two risk factors for type 2 diabetes.) In a mild form, it
can go undetected for many years. Untreated diabetes can lead
to many serious medical problems, including cardiovascular disease.

The other form is type 1 or juvenile diabetes. It typically begins
early in life. People with type 1 diabetes have a primary insulin
deficiency. They must take insulin to stay alive.

Diabetes is treatable, but even when glucose levels are under
control, it greatly increases the risk of heart disease and stroke.
In fact, most people with diabetes die of some form of heart or
blood vessel disease. Part of the reason for this is that diabetes
affects cholesterol and triglyceride levels. Often people with
diabetes also have high blood pressure, increasing their risk
even more.

When diabetes is detected, a doctor may prescribe changes in
eating habits, weight control and exercise programs, and even
drugs to keep it in check. It's critical for people with diabetes
to have regular check-ups. Work closely with your healthcare provider
to manage your diabetes and control any other risk factors. For
example, blood pressure for people with diabetes should be
lower than 130/85 mm Hg.

How dangerous is diabetes?

It's very dangerous. Just look at these facts:

Diabetes kills more than 60,000 Americans each year. Its
complications contribute to another 190,000 deaths.

People with diabetes are two to four times more likely to
have heart disease or a stroke. Their heart disease also tends
to be more severe. They have a higher risk of congestive heart
failure and other complications, too.

Diabetes causes nerve damage in the heart. This makes painless
heart attacks more likely and harder to diagnose. Heart attacks
are more likely to be fatal in people who have diabetes than
in those who don't.

Eighty to ninety percent of people with diabetes are overweight
or obese. Many people with diabetes also have high blood pressure
and aren't physically active. These factors raise their risk
for heart disease and stroke even more.

Nearly 60 million Americans have insulin resistance and 25
percent of them will probably go on to develop diabetes.

Note: Unless otherwise stated,
statistics given here are for the most recent year available and
are from the National Center for Health Statistics and the American
Heart Association, Heart and Stroke Statistical Update.

Besides being a risk factor for CVD, diabetes also can cause
or lead to:

blindness.

kidney disease.

nerve disease.

limb amputations.

Diabetes also can be debilitating and reduce the quality of life.
Many people with diabetes report depression and living a less-active
life.

Are people with diabetes at high risk for cardiovascular
diseases (CVD)?

Yes! People with diabetes are at high risk for such cardiovascular
disorders as coronary heart disease (heart attacks), stroke and
peripheral vascular disease. In fact, two out of three people
with diabetes die from CVD. A survey released by the American
Heart Association showed that only a third of diabetes patients
considered cardiovascular disease to be the most serious complication,
yet nearly two thirds of them already have experienced some form
of cardiovascular disease. At the same time, almost all these
patients admitted there were things they could do to prevent heart
problems.

The good news is that people with diabetes can reduce their risk
for cardiovascular disease.